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基于无残留病灶(R0 状态)的 IV 期结直肠癌患者腹膜播散的病理发现进行预后预测。

Prognostic predictions based on pathological findings of peritoneal dissemination in patients with stage IV colorectal cancer without residual disease (R0 status).

机构信息

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa, Nagoya, 464-8681, Aichi, Japan.

出版信息

Surg Today. 2019 Sep;49(9):755-761. doi: 10.1007/s00595-019-01800-1. Epub 2019 Apr 8.

Abstract

PURPOSE

This study aimed to clarify the prognosis of patients after resection of stage IV colorectal cancer and synchronous peritoneal metastasis (no residual disease: R0 status) based on histopathologic findings.

METHODS

The subjects of this study were 26 patients who underwent radical resection of synchronous peritoneal metastases of stage IV colorectal cancer. Only patients with one synchronous peritoneal metastasis were included in this study. The peritoneal lesions were initially classified into two categories based on the presence or absence of adenocarcinoma on their surface: RM-negative or RM-positive. The lesions were subsequently classified as being of massive or diffuse type and of small (< 6 mm) or large (≥ 6 mm) type according to the maximum metastatic tumor dimension.

RESULTS

Multivariate analysis revealed that massive type metastatic tumors were associated with a better disease-free survival (DFS; p = 0.047) and overall survival (OS; p = 0.033), than diffuse type tumors.

CONCLUSION

A detailed stratification of pathological findings could contribute remarkably to prognostic predictions for patients with synchronous peritoneal metastases.

摘要

目的

本研究旨在基于组织病理学发现,明确行根治性切除术治疗的 IV 期结直肠癌伴同步腹膜转移(无残留疾病:R0 状态)患者的预后。

方法

本研究的对象为 26 例接受 IV 期结直肠癌同步腹膜转移根治性切除术的患者。本研究仅纳入存在单个同步腹膜转移的患者。首先根据腹膜病变表面是否存在腺癌将其分为 RM 阴性或 RM 阳性;然后根据最大转移肿瘤直径将病变分为弥漫型或局限型(巨大型:>6mm;小结节型:<6mm)。

结果

多因素分析显示,与弥漫型转移瘤相比,巨大型转移瘤患者的无病生存(DFS;p=0.047)和总生存(OS;p=0.033)更好。

结论

对腹膜转移患者进行详细的病理发现分层,可显著有助于预后预测。

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